Skin Rash (Exanthema): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

• General physical examination – including blood pressure, pulse, body weight, height; further:
  • Inspection (viewing).
    • Skin (in terms of shape, the exanthema may be monomorphic (single-celled) or polymorphic (multiform); furthermore: localized or generalized)
      • [erythematous – associated with a reddening of the skin.
      • Hemorrhagic – associated with bleeding.
      • Macular – associated with the formation of spots
      • Morbilliform – accompanied by a rash similar to measles.
      • Papular – accompanied by the formation of nodules.
      • Pustular – associated with the formation of pustules (pustules).
      • Squamous – associated with the formation of scales.
      • Ulcerous – associated with the formation of ulcers
      • Urticarial – associated with the formation of wheals.
      • Vesicular – associated with the formation of vesicles.
      • Accompanied by the formation of:
        • Erosions (secondary skin or mucosal changes (efflorescence) characterized by a loss of the epidermis (epidermis) or, in the case of mucous membranes, the epithelium with the dermis (dermis) or mucosal own layer intact).
        • Crusts
        • Rhagades (fissures; narrow, cleft-like tear that cuts through all layers of the epidermis)]
    • Mucous membranes
    • Hairiness
    • Nails
• Dermatological examination [due todifferential diagnoses].
• Rheumatological examination [due todifferential diagnoses:
  • Behçet’s disease (synonym: Adamantiades-Behçet’s disease; Behçet’s disease; Behçet’s aphthae) – multisystem disease of the rheumatic type associated with recurrent, chronic vasculitis (vascular inflammation) of the small and large arteries and mucosal inflammation; The triad (the occurrence of three symptoms) of aphthae (painful, erosive mucosal lesions) in the mouth and aphthous genital ulcers (ulcers in the genital region), as well as uveitis (inflammation of the middle eye skin, which consists of the choroid (choroid), the ray body (corpus ciliare) and the iris) is stated as typical for the disease; a defect in cellular immunity is suspected
  • Reactive arthritis (synonym: postinfectious arthritis / joint inflammation) – secondary disease after gastrointestinal (gastrointestinal tract concerning), urogenital (urinary and genital organs concerning) or pulmonary (lungs concerning) infections; denotes an arthritis, where pathogens in the joint (usually) can not be found (sterile synovialitis).
  • Reiter’s disease (synonyms: Reiter’s syndrome; Reiter’s disease; arthritis dysenterica; polyarthritis enterica; postenteritic arthritis; posturethritic arthritis; undifferentiated oligoarthritis; urethro-oculo-synovial syndrome; Fiessinger-Leroy syndrome; English Sexually acquired reactive arthritis (SARA)) – special form of a “reactive arthritis” (see above. ); secondary disease after gastrointestinal or urogenital infections, characterized by the symptoms of Reiter’s triad; seronegative spondyloarthropathy, which is triggered especially in HLA-B27 positive persons by an intestinal or urinary tract disease with bacteria (mostly chlamydia); can manifest as arthritis (inflammation of the joints), conjunctivitis (inflammation of the conjunctiva), urethritis (inflammation of the urethra) and sometimes with typical skin changes. ]

Square brackets [ ] indicate possible pathological (pathological) physical findings.